Organization
OM MEDICAL CENTER LLC.
Active
Organization
OM MEDICAL CENTER LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DUSHYANT R PATEL MD (DOCTOR OWNER)
(201) 773-6868
Entity
Organization
Contact information
Practice address
12-15 BROADWAY STE B, FAIR LAWN, NJ 07410-2031
(201) 773-6868
(201) 773-6867
Mailing address
12-15 BROADWAY STE B, FAIR LAWN, NJ 07410-2031
(201) 773-6868
(201) 773-6867
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0108871
—
NJ
Enumeration date
09/16/2006
Last updated
06/08/2010
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